QPANA Annual Membership Registration

THE QUEBEC PERIANESTHESIA NURSES ASSOCIATION (QPANA)

The member registration fee includes membership to the National Association of PeriAnesthesia Nurses of Canada (NAPANc), participation at the General Assemblies, reduced conference fees and access to the member’s area of QPANA’s website (www.aipaq.org) and more. As well as supporting the efforts of the Association in making perianesthesia nursing a recognized specialty. Members may take advantage of reduced fees for the provincial & national annual conference.

Membership Categories*

Active Members: Shall be a member in good standing with the OIIQ who shall be involved at least part-time in perianesthesia care in the following settings: Pre-Admission/Preoperative Clinic, Post-Anesthesia Care Unit, day/ambulatory surgery, or working in any specialty area where the nurse is directly involved in the care of patients in the perianesthesic phase; including management, teaching or research, Active members have the right to vote and to serve on Executive Committee.Associate Members:Shall be nurses, retired nurses, physicians, or other health care practitioners interested in perianesthesia care. Except for those members who are already serving on the Executive Committee, associate members shall not vote nor serve on the Executive Committee.

* Membership card is effective from April 1 of the current year to March 31 of the next year

Payment Method

Payment could be sent by mail or it could be securely paid online through PayPal:

By mail: Please go to the section "Membership" of the website to obtain the printable membership registration form, fill in the form and send it with a check payable to: QPANA, PO Box 93 , station St-Michel, Montreal, Quebec, H2A 3L8

On line through PayPal, please continue by pressing "Next" at the bottom of this page

Registration Fees

Membership Categories

Annual Fees

New Active Membership

30.00$

Renewal Active Membership

30.00$

New Associate Membership

30.00$

Renewal Associate Membership

30.00$

OIIQ (Order of Nurses of Quebec) permit #(*)

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Your Name(*)

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Family Name(*)

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Title (Mr, Mrs, Miss, Ms)

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Address(*)

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City(*)

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Province(*)

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Postal Code(*)

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Home phone number(*)

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Work Phone number(*)

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Home e-mail

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Work e-mail(*)

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Employer(*)

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Practice Setting(*)

Preoperative/Preadmission

PACU/Recovery Room

Ambulatory Surgery/Day Surgery

Private Office

Operating Room

Special Procedure/Interventional Radiology

Other

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Please specify(*)

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Professional Status(*)

RN

Head Nurse

Assistant Head Nurse

Team Leader

Clinical Nurse

Clinical Nurse Specialist

Coordinator/ Supervisor

Other

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Please specify(*)

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Position(*)

Full Time

Part Time

Float Team

Availability

Retired

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Education(*)

Diploma Nursing

BS / BA Nursing

BS/BA other field

MS Nursing

MS/MA other field

ICU course

PACU course

Other

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Please specify(*)

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I understand that as a member, I authorize QPANA: to use any photos taken, within the frame work of all QPANA activities and to submit my provincial membership information to NAPANc(*)

Yes

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How did you hear about QPANA?

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Annual QPANA Membership Fee

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Total

0.00 CAD

Are you registered as a member of QPANA?

Perianesthesia nurses promote a multi-disciplinary relationship with all members of the health care team.+